Angela Jetter
Speech-Language Pathologist, in Canyon Lake, TX. Individual provider (NPI-1).
NPI number1891052247
StatusActive
Last updated in NPPESDec 17, 2025
Details
- NPI
- 1891052247
- Entity type
- Individual (NPI-1)
- Name
- Angela Jetter
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 23, 2012
- Certification date
- Dec 17, 2025
- Last updated
- Dec 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 101225 | TX | Yes |
Practice location
42111 Fm 3159Canyon Lake, TX 78133-4948
Phone 281-687-0912
Mailing address
1634 Trail Pass DrCanyon Lake, TX 78133-4872
Phone 281-687-0912
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